Abstract:
:Gene transfer to the tracheobronchial tree has been an active area of investigation since the discovery of the genetic defect in the cystic fibrosis transmembrane conductance regulator over two decades ago. Cystic fibrosis (CF) is the most common lethal monogeneic disorder for which there is no cure short of lung transplantation. The ultimate goal of gene therapy in CF is to achieve efficient gene transfer at a level and distribution in target tracheobronchial epithelial cells and submucosal gland cells, which results in the genotypic and phenotypic correction of CF. This article reviews the current challenges and limitations of postnatal gene therapy to the tracheobronchial tree, and the potential advantages of fetal gene therapy for CF. We review recent work with novel viral vectors to achieve extremely efficient gene transfer in target cells in the respiratory epithelium and submucosal glands in models that are representative of the developing human fetal trachea. Finally, we will examine the prospects for, limitations of, and regulatory challenges facing the translation of fetal gene therapy from research to clinical application.
journal_name
Semin Pediatr Surgjournal_title
Seminars in pediatric surgeryauthors
Keswani SG,Crombleholme TMdoi
10.1053/j.sempedsurg.2003.09.007keywords:
subject
Has Abstractpub_date
2004-02-01 00:00:00pages
44-52issue
1eissn
1055-8586issn
1532-9453pii
S1055858603000659journal_volume
13pub_type
杂志文章,评审abstract::The practice of pediatric surgery is at the crossroads of 2 specialties, pediatrics and surgery. At that vantage point, many ethical dilemmas can be seen. It is important for the pediatric surgeon to understand the special place of ethics in the care of children and how that care is influenced by society. The purpose ...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章,评审
doi:10.1053/spsu.2001.26837
更新日期:2001-11-01 00:00:00
abstract::Slipping rib syndrome (SRS) is an under-diagnosed cause of intermittent, yet often debilitating lower rib and abdominal pain. SRS is caused by a hypermobility of the anterior false ribs that allows the 8th-10th ribs to slip or click as the cartilaginous rib tip abuts or slips under the rib above. Pain occurs from impi...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章,评审
doi:10.1053/j.sempedsurg.2018.05.009
更新日期:2018-06-01 00:00:00
abstract::Pediatric trauma is usually a nonoperative experience for the pediatric general surgeon. The pediatric trauma surgeon resuscitates the child and then evaluates and triages the identified injuries. A common diagnostic tool is the computed tomography (CT) scan. Most children who require evaluation for significant trauma...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章,评审
doi:10.1053/j.sempedsurg.2010.06.004
更新日期:2010-11-01 00:00:00
abstract::Congenital diaphragmatic hernia (CDH) is a common structural birth defect that affects approximately 1 in 2500 live births. Although the exact etiology of most cases of CDH remains unknown, it is becoming increasingly clear that genetic factors play an important role in many cases of CDH. In this paper, we review crit...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章,评审
doi:10.1053/j.sempedsurg.2007.01.003
更新日期:2007-05-01 00:00:00
abstract::Enterocolitis remains a relatively common complication of Hirschsprung's disease with significant morbidity and mortality. The etiology of Hirschsprung's enterocolitis (HEC) is multifactorial and remains poorly understood. Preventative measures and better treatment modalities will evolve out of a better understanding ...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章,评审
doi:10.1053/j.sempedsurg.2004.10.014
更新日期:2004-11-01 00:00:00
abstract::Enhanced recovery after surgery (ERAS) has evolved over the past two decades. Originally aimed to standardize care among adults undergoing colorectal surgery, the tenets that developed have since been broadly accepted by a large number of adult surgical subspecialties, including bariatric surgery. This multidisciplina...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.sempedsurg.2020.150885
更新日期:2020-02-01 00:00:00
abstract::Hirschsprung (HSCR) disease is a relatively common neonatal developmental disorder of the enteric nervous system and is characterized by the absence of ganglion cells in the myenteric and submucosal plexuses of the distal intestine. This results in absent peristalsis in the affected bowel, and the development of a fun...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章
doi:10.1053/j.sempedsurg.2004.10.027
更新日期:2005-02-01 00:00:00
abstract::A malignant tumor of striated muscle origin, rhabdomyosarcoma (RMS) is a childhood tumor that has benefited from nearly 30 years of multimodality therapy, culminating in a >70% overall 5-year survival. Prognosis for RMS is dependent on primary tumor site, age, completeness of resection, presence and number of metastat...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章,评审
doi:10.1053/j.sempedsurg.2016.09.011
更新日期:2016-10-01 00:00:00
abstract::An examination of and recommendations regarding the approval process for medical devices are presented. The typical pathways and hurdles laid out by the Federal Food and Drug Administration (FDA) are discussed, and options for marketing and use of medical devices are addressed. The first step in the regulatory process...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章,评审
doi:10.1053/j.sempedsurg.2006.07.009
更新日期:2006-11-01 00:00:00
abstract::The field of intestinal transplantation has experienced dramatic growth since the first reported cases 3 decades ago. Improvements in operative technique, donor assessment and immunosuppressive protocols have afforded children who suffer from life-threatening complications of intestinal failure a chance at long-term s...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章,评审
doi:10.1053/j.sempedsurg.2017.07.007
更新日期:2017-08-01 00:00:00
abstract::Vascular liver tumors in the pediatric population can present a diagnostic dilemma. The most common hepatic vascular tumors are hepatic hemangiomas; however the differential diagnosis can also include other benign lesions and malignant masses. Management is unique to the type and nature of the specific lesion. Thus, c...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.sempedsurg.2020.150970
更新日期:2020-10-01 00:00:00
abstract::Survey methodologies enable researchers to obtain information not routinely captured in electronic medical records, including how delivery of surgical care is perceived through the lens of a child, a parent or caregiver, or a surgeon. Here we describe the approach to using surveys to aid pediatric surgery practice. Th...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章,评审
doi:10.1053/j.sempedsurg.2018.10.007
更新日期:2018-12-01 00:00:00
abstract::Identification of CDH infant populations at high risk for mortality postnatally may help to develop targeted care strategies, guide discussions surrounding palliation and contribute to standardizing reporting and benchmarking, so that care strategies at different centers can be compared. Clinical prediction rules are ...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章,评审
doi:10.1053/j.sempedsurg.2017.04.010
更新日期:2017-06-01 00:00:00
abstract::Palliative care is now a core component of pediatric care for children and families who are confronting serious illness with a low likelihood of survival. Pediatric surgeons, in partnership with pediatric palliative care teams, can play a pivotal role in assuring that these patients receive the highest possible qualit...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章,评审
doi:10.1053/j.sempedsurg.2013.05.004
更新日期:2013-08-01 00:00:00
abstract::The importance of having a reproducible scoring system to objectively assess the severity of fecal incontinence and its response to treatment is stressed, and a number of methods are described. The approach to conservative treatment and investigation is outlined. Recent advances in the surgical management of fecal inc...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章,评审
doi:10.1053/spsu.2002.31806
更新日期:2002-05-01 00:00:00
abstract::The fallopian tubes are the essential genital ducts that convey the female sex cells for fertilization. They are differentiated and detectable early in fetal life. There are numerous paratubal and tubal abnormalities that can occur at any point in the female life. Some of these are rare but may initiate significant mo...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章,评审
doi:10.1053/j.sempedsurg.2005.01.009
更新日期:2005-05-01 00:00:00
abstract::Although most patients with esophageal atresia (EA) and tracheo-esophageal fistula (TEF) may benefit from "standard" management, which is deferred emergency surgery, some may present unexpected elements that change this paradigm. Birth weight, associated anomalies, and long gap can influence the therapeutic schedule o...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章,评审
doi:10.1053/j.sempedsurg.2014.09.006
更新日期:2014-10-01 00:00:00
abstract::The outcome for children with congenital enteropathies or massive surgical resections has improved significantly over the past two decades. Advances in understanding of the pathophysiology of intractable diarrhea and of the mutations causing many of the congenital enteropathies have enabled initiation of preventive me...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章,评审
doi:10.1053/j.sempedsurg.2009.11.003
更新日期:2010-02-01 00:00:00
abstract::Most children with short bowel syndrome experience spontaneous small bowel adaptation over time. This allows the majority to be weaned from parenteral nutrition. There are, however, some children who cannot be weaned and are potential candidates for techniques to promote intestinal adaptation and intestinal lengthenin...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章,评审
doi:10.1053/spsu.2001.22855
更新日期:2001-05-01 00:00:00
abstract::In the United States nearly 2 million people are burned every year; about 100,000 burns are moderate to severe and require hospitalization and about 5,000 deaths occur because of burns. The overall improvement in mortality and outcome of patients with severe burn trauma over the last decades can be attributed to the f...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章
doi:10.1053/spsu.2001.19389
更新日期:2001-02-01 00:00:00
abstract::Traditionally, pediatric surgical education consisted of exposure to patients, textbooks, lectures, team-based education, congresses, and workshops. Over the last decades, however, new information technology (IT) and the internet revolutionized the sharing of information and communication. IT has become relevant in pa...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章,评审
doi:10.1053/j.sempedsurg.2015.02.012
更新日期:2015-06-01 00:00:00
abstract::Inflammatory bowel disease in childhood refers to ulcerative colitis, Crohn's disease, and colitis of an indeterminate type. Their gross and microscopic features are discussed along with the differential diagnosis from other childhood conditions associated with bloody diarrhea. ...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章,评审
doi:10.1053/j.sempedsurg.2007.04.005
更新日期:2007-08-01 00:00:00
abstract::Management of pediatric intestinal failure has evolved in recent decades, with improved survival since the advent of specialized multidisciplinary intestinal failure centers. Though sepsis and intestinal failure associated liver disease still contribute to mortality, we now have growing data on the long-term outcomes ...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章,评审
doi:10.1053/j.sempedsurg.2017.09.006
更新日期:2017-10-01 00:00:00
abstract::Conventional treatment of respiratory failure involves positive pressure ventilation with high concentrations of inspired oxygen. If adequate gas exchange still cannot be achieved extracorporeal membrane oxygenation (ECMO) may be an option. The general indication for ECMO for respiratory insufficiency is a reversible ...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章,评审
doi:10.1053/j.sempedsurg.2007.10.006
更新日期:2008-02-01 00:00:00
abstract::Soft tissue sarcomas of childhood are a heterogenous group of tumors with a wide spectrum of presentations and outcomes. Most patients require multimodal therapy with chemotherapy, surgery and/or radiation. Improved outcomes in recent decades have been achieved through improvements in the comprehensive care of these c...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.sempedsurg.2019.150862
更新日期:2019-12-01 00:00:00
abstract::Obesity affects 50% of adults and 18% of children in the USA. It has wide-ranging comorbidities with clinical, psychosocial, and economic ramifications. Obesity refers to a condition of excess body fat. The basis for weight gain is a fundamental imbalance between caloric intake and output, but individual variation bas...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章
doi:10.1053/j.sempedsurg.2009.04.008
更新日期:2009-08-01 00:00:00
abstract::Nephron-sparing surgery (NSS) is the treatment of choice for children with bilateral Wilms' tumor (WT), or with WT on a single kidney, or with WT and a disease of the contralateral kidney, or with benign kidney tumor. NSS is a reasonable alternative to nephrectomy in children at risk of metachronous WT, including chil...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章,评审
doi:10.1053/j.sempedsurg.2005.11.002
更新日期:2006-02-01 00:00:00
abstract::Until the 1970s, bladder exstrophy was a frequently fatal birth defect that, at the very least, conferred a shortened life span with devastating consequences for afflicted patients. Beginning with the modern era of surgical management, survival has become routine, and now the focus is on optimizing a near-normal retur...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章,评审
doi:10.1053/j.sempedsurg.2011.01.001
更新日期:2011-05-01 00:00:00
abstract::Progressive familial intrahepatic cholestasis (PFIC) and Alagille syndrome (AS) are conditions caused by either an autosomal recessive or an autosomal dominant genetic defect, and they are both characterized by cholestasis, jaundice, and severe debilitating pruritus refractory to medical management. Before the advent ...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.sempedsurg.2020.150946
更新日期:2020-08-01 00:00:00
abstract::The increase in multiple gestation pregnancies has resulted in significant health care implications for both mother and child. Our ability to diagnose and intervene on an at-risk multi-gestation pregnancy has dramatically improved. It is important for the pediatric surgeon to be equipped with a basic fund of knowledge...
journal_title:Seminars in pediatric surgery
pub_type: 杂志文章,评审
doi:10.1053/j.sempedsurg.2019.07.008
更新日期:2019-08-01 00:00:00